ABSTRACT
Over the past two decades, processes of globalization have radically altered the intensity, scale, pace and diversity of global connections. The movement of individuals and groups has in turn been facilitated by the growth of global communication and transportation, as well as by the existence of social networks and groups of people who have already migrated, and who can help family members and friends settle into a new society. While globalization has strengthened economic links across regions, changing demographics, inequalities of opportunity, conflict and unrest, changes in sociocultural norms and expectations, and the pursuit of individual desire and aspiration have also – in varying ways – intensified the tendencies for people to move across and within regions, nations and localities. As population movement becomes more complex, concerns have been voiced
about potential links between mobility, health and wellbeing in general, and about the possibility of transmission of infectious diseases in particular. Since it creates a bridge between regions and peoples that had been socially and spatially isolated, population mobility has long been linked to disease outbreaks and epidemics (Kraut 1995; Apostolopoulos and Sonmez 2007; Jatrana et al. 2007). This historical concern about mobility and infectious diseases became particularly apparent in recent times with widespread fears – at least in the early years of the epidemic – about the transmission of HIV. In the 1980s and early 1990s the global imagination surrounding AIDS was fed by a plethora of fear-producing images (Patton 2002). Such fears also influenced a popularly perceived need to in some way contain or control various migrant populations (Coker 2003), and have also played a role in fuelling debates linking HIV with issues of global security and surveillance (Prins 2004; Ingram 2005). Certainly influenced by such fears, or more specifically by concerns regarding
the nourishing of such fears and of stigmatising mobile populations, much of the initial published literature on migration and HIV was very prudent. Relatively little was published, and, along with much of the research concerning HIV and AIDS at the time, what did appear remained largely epidemiological and behavioural in nature. By the mid-1990s, however, and within HIV and AIDS research, the limitations of behaviouralist approaches to understanding the
transmission of the virus were becoming evident, leading to increased academic and policy-based recognition that HIV and AIDS were not solely medical issues but were best understood through a broad ‘biosocial’ lens (Farmer 1999). This more socially oriented focus allowed the epidemic to be considered in relation to wider economic and cultural processes, and within the broader structures and meanings that shape sexual experience in different contexts and settings (Herdt 1997; Parker et al. 2000; Parker 2001; Manalansan 2006). Following the same trends, much of the literature on HIV and migration since
that time has thus focused on the specific HIV-related risks and vulnerabilities experienced by mobile populations, the communities that host them, and the communities to which they return. Those involved in labour migration have received particular attention, especially men who move from developing areas in search of improved livelihood opportunities in other regions, countries or continents (see, for example, Campbell 1997; Lurie et al. 2003). More recently, however, the scope of interest has widened to examine ‘mobile’ populations, thus taking into account the increasingly wide array of situations, circumstances and time scales within which people from a diverse variety of countries and backgrounds move from place to place. Key populations include, amongst others, migrant labourers, refugees, internally displaced people, sex workers, tourists, professionals and people returning ‘home’. In addition, increasing attention has been paid not only to the diversity of the ways in which globalisation processes bring these groups into contact with host and home communities, but also to the ways in which they may interact with one other. Largely as a result of the HIV pandemic, recognition of the more holistic
contexts and processes which shape sexual experience, and the emergence of intellectual interest in feminism, ethnic studies and lesbian, gay, bisexual, transgender and queer studies, the past two decades have seen a parallel surge in the development of academic work on human sexuality (Kimmel and Plante 2004; Parker and Aggleton 2007). Importantly, however, it is really only in the past decade that the study of sexuality in the context of transnational and global mobility has intensified, with literature now appearing in the fields of anthropology, sociology, geography, history, and public health. Two key lines of enquiry have developed as these relate to HIV and AIDS. The first looks at the ways in which mobility can influence self-perceptions and actions as people move, and find themselves exposed to what Herdt (1997:3) describes as new ‘cultures of sexuality’. Secondly, more recent literature has begun to recognize that far from homogenizing ideas about sexuality, processes of globalization have often hybridized sexual ideologies, behaviours and identities. It is increasingly recognized that many of the categories, conceptions and models used in a Western context to describe these ideologies, behaviours and identities can neither be applied universally, nor considered static (Parker 2001; Manalansan 2006). Despite this more ‘insider’ approach to understanding sexuality, the nature
and legacy of the HIV pandemic have overwhelmingly been to problematize sexual experience, particularly in research related to sexuality and health. As
many of the chapters in this book argue, understanding the various risks and vulnerabilities faced by some mobile populations with regards to HIV and AIDS – as well as those of host and home communities – remains a key concern for HIV-based policy, programming and intervention which cannot, and must not, be ignored. However increased recognition of the social and cultural construction of sexuality – and of the various ways in which HIV and the social spaces created by population movement can themselves be conceptualized and experienced – raises important questions with respect to the risk and vulnerability faced by people who are mobile, and by those with whom they interact. Recognition that the ways in which a person’s sexuality – or the ways his or
her sexuality is perceived by others – can influence his or her situation, has taken place in parallel with wider trends within the social sciences which stress the importance of actor agency, adaptation and resilience for understanding the fluidity and diversity of lived experience. Mobility, Sexuality and AIDS attempts to consolidate some of the key developments which have emerged across the social sciences which bring together this array of issues in their examination of the interface between mobile individuals and populations, sexuality, HIV and AIDS. The volume emerged from the editors’ sense of the potential importance of such insights for those working at the intersections of mobility and health, either as practitioners or as academics. We felt that this new book could help increase understanding of the complex inter-linkages between these new insights, and deepen knowledge of the heterogeneous priorities, needs, actions and experiences of different mobile populations, and of the home and host communities with whom they liaise. We have tried to organize the book in a way that will provide insight as to
how mobility, sexuality, HIV and AIDS intersect within the wider social, political, economic and cultural structures and processes that take place at different scales: from the micro level of the family and household to the macro levels of health-related policy making. In so doing, we have organized not by geographical region or by migration trajectory, but have identified three over-arching themes which recur in the chapters that make up the volume: mobility and the experience of the self, mobility and pleasure, and mobility and work. Particular issues – such as increasing mobility of women, the need to examine the interconnections between structure and agency, the potential importance of the church, or the unintended consequences of seemingly benevolent labour migration policies – appear in a number of the chapters. Similarly, movement between certain geographical areas where research on mobility, sexuality and HIV has been particularly strong, such as Central America and the USA, or between various countries in Africa, is discussed in several different sections. Chapter 1 sets the context by providing an important overview of epidemio-
logical studies of HIV prevalence amongst international migrants compared with the populations of destination countries. While it has frequently been hypothesized that the HIV-related risks that result from mobility increase migrants’ exposure to HIV and increase the likelihood of its transmission, Islene Araujo de
Carvalho, Mary Haour-Knipe and Karl L. Dehne stress the often overlooked fact that relatively little rigorous evidence exists to support such claims. What studies are available are often based on small sample sizes, tend to focus on migrants from areas with generalised HIV epidemics, and over-represent migrants from groups considered to be at heightened risk of HIV transmission. The authors call for the creation of more solid evidence on which to base important policy formulation, and for more nuanced accounts concerning links between mobility, sexuality and HIV.
